FVN Chapter 388
Chapter 388
New patients walked into the consultation room.
This is a 28-year-old woman, white-collar worker, quite young and beautiful.
When I walked in, I had a coughing sound.
"Doctor Lin..."
"What's the situation?"
"Ahem... I coughed this for almost a year... Basically coughing every day..."
Lin Feng nodded.
Coughing every day, coughing for a year, that is considered a chronic cough.
Lin Feng asked student Chen Qingru: "Tell me, what are the common causes of chronic cough?" "
Chen Qingru thought for a while: "The most common causes of chronic cough are: cough variant asthma, gastroesophageal reflux cough, postnasal drip syndrome, eosinophilic bronchitis, allergic cough, etc., these 5 causes account for about 80% of the causes of chronic cough..."
Lin Feng nodded,
That's a decent answer.
Lin Feng asked the female patient: "Have you ever seen a doctor?" "
Female patient: "I have visited 2 hospitals, and I have taken a lot of cough medicine, which is useless..."
Lin Feng: "Is there an inspection report?" Show me? "
Female patient: "Didn't bring ..."
Lin Feng: "..........................."
If there is no inspection report, it may cost a lot of money to carry out the inspection.
There are too many causes of coughing, and Lin Feng can name 30 common causes of cough in one minute.
"Is it a sudden cough? Or is it coughing because of some disease? "
"Sudden cough."
"Is there phlegm?"
"Most of the time not, sometimes there is a little white phlegm..."
Asked some others, nothing particularly found.
At this time, Lin Feng first ruled out pneumonia,
Because, this patient has been coughing for a year, pneumonia is generally an acute course, rarely said to have chronic pneumonia.
Lin Feng listened to his heart and lungs,
Sure enough, I didn't hear the crackles that pneumonia must have.
"Go for a chest CT, after all, such a long cough, there will definitely be a little problem with the lungs, which can provide clues."
"Okay..."
Lin Feng billing,
Important CT to do, in addition, blood routine must be checked, anyway cheap.
......
Next
Busy until the end of the afternoon,
After Lin Feng diagnosed the patient, he stretched his muscles.
suddenly
He thought of the young female patient.
"What's going on?"
"That female patient, why hasn't she come to me yet? It stands to reason that the inspection report should come out? "
Lin Feng opened the computer with doubts and entered the patient information system,
Recall the test results:
The results of the 2 inspections came out.
Blood draw: white blood cells are normal, other items are normal... (Time: 16:12)
· CT: 3cmX2CM high-density shadow in the lungs, and the edges are not straight, consider malignant tumors... (Time: 16:34)
Lin Feng saw the CT results,
Frowned all at once!
The worst, happened!
The imaging department actually suggested that it was a malignant tumor!
"Why didn't the patient come to me? Can't you think about it...? "
Thinking of this, Lin Feng quickly picked up the phone and dialed the patient's mobile phone number.
Bell bell bell ~~~~~
After a long time,
to connect.
"Hey... Who? "
On the other side, the female patient's voice was hoarse, and she probably cried for a long time.
Lin Feng: "I am Lin Feng... Where have you been? The inspection reports are all out, why don't you look for me? "
The female patient was weak: "Dr. Lin... I'm not cured, anyway, lung cancer can't be cured..."
Lin Feng was 'very angry': "Who said you have lung cancer?" Toss blindly, hurry back, the diagnosis of the imaging department does not say anything..."
"Huh? Dr. Lam... I..."
The tone of the female patient became pleasantly surprised.
"Me what me? Hurry back, I'm leaving work... I read your CT, there are seven or eight possibilities, not necessarily lung cancer..."
Lin Feng said very roughly.
"Okay, okay, I'll go back right away..."
The hope of life makes the female patient's voice full of fresh breath.
soon
The female patient ran all the way, with tears in the corners of her eyes and hope on her face, and ran into Lin Feng's consultation room.
"Doctor Lin, am I really all right?"
"CT is just a reference, it is not a pathology, not a final diagnosis, so this lung cancer is just suspicious, don't worry about it..."
Although CT is very accurate, it is only an imaging method after all, and it can only be referenced.
So what method can identify lung cancer?
Pathology!
Only take the tissue out and do pathology!
This can really prove whether it is lung cancer!
"How do you take that?"
"It can be surgically, or bronchoscopy... Or direct PET-CT... However, although PET-CT is non-invasive and painless, it is very expensive, tens of thousands of yuan at a time, and I recommend surgery or bronchoscopy. "
Lin Feng explained the details of the three methods.
The female patient thought that PET-CT was painless and good at first, but when she heard that it would cost tens of thousands of yuan to do it, she could not be reimbursed, so she gave up directly.
"I'll choose a bronchoscope..."
"Good."
Bronchoscopy, similar to gastroscopy.
billing,
Let the patient pay, then go to the respiratory medicine department and let the respiratory department do it for her.
It just so happened that Lin Feng did a favor to the respiratory medicine department in the morning, so the respiratory medicine department agreed very quickly, and also rushed the kind.
Human relationships are reflected here.
......
In the respiratory medicine department, it took 10 minutes to enter the right lung mass site.
"Hey, this doesn't look like a tumor..."
The experienced doctor of the respiratory medicine department saw the photos taken by the laser mirror and thought that it was not a tumor.
When the local anesthetic patient heard the doctor of respiratory medicine say this, he immediately cried with excitement, lying on the bed, tears flowing.
Take out the tissue...
Sent for inspection...
......
......